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Abstract：
Background: The intervention Complexity Assessment Tool for Systematic Reviews (iCAT_SR) has been developed to facilitate detailed assessments of intervention complexity in systematic reviews. Worked examples of the tool\'s application are needed to promote its use and refinement. The aim of this case study was to apply the iCAT_SR to a subset of 20 studies included in a Cochrane review of interventions aimed at improving appropriate polypharmacy in older people. Methods: Interventions were assessed independently by two authors using the six core iCAT_SR dimensions: (1) \'Target organisational levels/categories\'; (2) \'Target behaviour/actions\'; (3) \'Active intervention components\'; (4) \'Degree of tailoring\'; (5) \'Level of skill required by intervention deliverers\'; (6) \'Level of skill required by intervention recipients\'. Attempts were made to apply four optional dimensions: \'Interaction between intervention components\'; \'Context/setting\'; \'Recipient/provider factors\'; \'Nature of causal pathway\'. Inter-rater reliability was assessed using Cohen\'s Kappa coefficient. Disagreements were resolved by consensus discussion. The findings are presented narratively. Results: Assessments involving the core iCAT_SR dimensions showed limited consistency in intervention complexity across included studies, even when categorised according to clinical setting. Interventions were delivered across various organisational levels and categories (i.e. healthcare professionals and patients) and typically comprised multiple components. Intermediate skill levels were required by those delivering and receiving the interventions across all studies. A lack of detail in study reports precluded application of the iCAT_SR\'s optional dimensions. The inter-rater reliability was substantial (Cohen\'s Kappa = 0.75) Conclusions: This study describes the application of the iCAT_SR to studies included in a Cochrane systematic review. Future intervention studies need to ensure more detailed reporting of interventions, context and the causal pathways underlying intervention effects to allow a more holistic understanding of intervention complexity and facilitate replication in other settings. The experience gained has helped to refine the original guidance document relating to the application of iCAT_SR.
摘要：
背景：系统评价干预复杂性评估工具（iCAT_SR）已经开发出来，以促进系统评价中干预复杂性的详细评估。需要使用该工具的应用程序的实例来促进其使用和改进。本案例研究的目的是将iCAT_SR应用于Cochrane评估旨在改善老年人适当的多重用药干预措施中的20项研究的子集。方法：两位作者使用六个核心iCAT_SR维度独立评估干预措施：（1）“目标组织水平/类别”；（2）“目标行为/行动”；（3）“主动干预组件”；（4）“定制程度”；（5）“干预交付者所需的技能水平”；（6）“干预接受者所需的技能水平”。尝试应用四个可选维度:\'干预组件之间的交互\';\'上下文/设置\';\'接收者/提供者因素\';\'因果途径的性质\'。使用科恩的Kappa系数评估评分者间的信度。通过协商一致讨论解决了分歧。研究结果以叙述方式呈现。结果：涉及核心iCAT_SR维度的评估在纳入研究的干预复杂性方面表现出有限的一致性，即使根据临床环境进行分类。干预措施跨各种组织级别和类别（即医疗保健专业人员和患者）进行，通常包括多个组成部分。在所有研究中，提供和接受干预措施的人员都需要中等技能水平。研究报告中缺乏细节，无法应用iCAT_SR的可选尺寸。评估者之间的可靠性很高（Cohen的Kappa=0.75）结论：本研究描述了iCAT_SR在Cochrane系统评价中的应用。未来的干预研究需要确保更详细的干预报告，背景和潜在的干预效果的因果途径，以便更全面地了解干预的复杂性，并促进在其他环境中的复制。获得的经验有助于完善与iCAT_SR的应用有关的原始指导文件。
